• Xiaopeng Liang, Oscar Hou In Chou, and CheungBernard M YBMYDivision of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China; State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Pokfulam.
• Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong, China.
• Am. J. Med. 2023 Mar 1; 136 (3): 294301.e2294-301.e2.

BackgroundHuman papillomavirus (HPV) infection has been proposed to be an unconventional risk factor for cardiovascular diseases. We investigated the association between HPV infection and cardiovascular diseases among women with or without HPV vaccination.MethodsThis cross-sectional study included 9,353 women aged between 20 to 59 years old who were tested for vaginal HPV DNA in the National Health and Nutrition Examination Survey (NHANES) 2003-2016. Cardiovascular diseases were defined as the presence of self-reported coronary heart diseases, heart attacks, angina pectoris, and stroke. The association between HPV and cardiovascular diseases was studied using logistic regression, with adjustment for the potential confounders.ResultsA total of 40.8% of women were HPV DNA positive; 3.0% had cardiovascular diseases; and 9.0% of women received the HPV vaccine. The presence of vaginal HPV infection was associated with cardiovascular diseases (odd ratio [OR] = 1.66, 95% confidence interval [CI] 1.28-2.16), which remained significant (OR = 1.54, 95% CI 1.15-2.08) after adjustment for sociodemographic characteristics, lifestyle behaviors, medical history, family history of cardiovascular diseases, and antihypertensive drugs. The association was absent among those who were vaccinated against HPV (OR= 0.50, 95% CI 0.07-3.51) but present among those who were not (OR = 1.63, 95% CI 1.18-2.25).ConclusionsThere was an association between HPV infection and cardiovascular diseases. This association was not significant among women vaccinated against HPV. The effect of HPV vaccination on cardiovascular diseases requires further investigation.Copyright © 2022 Elsevier Inc. All rights reserved.

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